By MIKE MCGEE
The Dallas Examiner
Even in the midst of the global COVID-19 outbreak, the more ordinary medical needs of the public continue just as they always have. An aspect of that was addressed during the Men in Pain: Creating Open Dialogues & Pathways to Better Outcomes online broadcast Sept. 29
The virtual meeting, supported by The Men’s Health Network and the Men’s Health Caucus of the American Public Health Association, provided panelists to assist viewers in understanding the unique challenges and needs of men who experience chronic pain and how treatment innovations and open conversations on the topic can improve outcomes for men of all ages.
The subject of male chronic pain management may hit close to home for many. The July 2019 population estimate for Dallas County was 2,635,516, per the U.S. Census Bureau. Of that number, 49.3% were men.
That data can also be coupled with the ongoing problem of pain treatment inequities in the medical field for Black Americans in general. In January of this year, Dr. Janice A. Sabin published a report on the Association of American Medical Colleges website entitled How We Fail Black Patients in Pain.
With finding a more equitable treatment of pain as the goal, Sabin noted the results of a 2019 study that demonstrated the unintentional, but no less real, disparity in pain treatment between Blacks and Whites.
The study “asked subjects to identify pain expressed in photos found that White participants more readily recognized pain on White faces than on Black faces,” the doctor penned.
“Although providers might like to believe that they do not harbor unconscious biases, research shows that they are just as likely as others to do so.”
Armin Brott, writer, fatherhood advocate and creator of the online entity Mr. Dad, began the webinar by clarifying what chronic pain is, as opposed to the more common acute, or sudden, pain.
“Chronic pain … is considered pain that lasts for more than 6 months.” It can be caused by something sudden like an accident or be a part of a long-term condition, such as arthritis, aging, military service or repetitive movement.
Brott’s own pain is a result of his years of martial arts training.
“According to the CDC there are 50 million Americans living with chronic pain in the United States,” he continued, as he provided background information.
When that number is divided between the sexes more women report being in chronic pain.
However, Brott noted, “Men typically don’t admit to themselves or to anyone else that they’re in pain, and they generally don’t seek treatment for pain, so they’re way underreported,” leading to those suffering from such pain to a ratio of about 50-50 for men and women, he estimated.
The writer further pointed out that 10 million men have chronic pain that limits one activity; for a third of those people, the pain is so bad that they have issues with self-care, such as bathing, dressing, working, eating or driving to pick up their children. The financial cost of pain treatment, including disability payments, is estimated by the CDC to cost $560 billion a year.
Such pain that is expensive, life altering and can even lead to substance abuse or suicide, makes proper care imperative. Dr. Sal Giorgianni, Senior Science Advisor at the MHN, offered information on better health management for men and their doctors.
“It’s not a trivial condition and it really is something that people, sometimes, if they have chronic pain, just don’t understand,” he offered. When comparing men, women and health care issues such as diabetes, heart disease and cancer, the doctor said, “Even with pain… guys are very early on enculterated to think about getting up and taking it like a man.”
It is a lifetime outlook, Giorgianni remarked, so that men who talk or complain about pain may feel like they are not fulfilling their male role. This leads to some in chronic pain turning only to medication in hope of relief, or exercise, which may exacerbate the physical issue generating the pain.
“Pain is God’s way of telling you something’s wrong. It’s your body’s way of talking to you so, as women do, you’ve got to listen to your body.”
He said that a better approach would be if men kept a pain diary, or became more aware of their cycles of pain, rather than “letting the pain get ahead of them” so that heavy medication becomes the last resort instead of more measured preventative care by a physician.
Brandon Leonard, chair-elect of Men’s Health Caucus of the American Public Health Association, built upon some of these concepts as he discussed personalized pain care.
“For many patients … the most effective treatment for their pain will involve a combination of approaches,” he affirmed as he mentioned non-addictive drug treatments like physical therapy, cognitive behavioral therapy, yoga, massage, acupuncture, along with physician care.
He did caution, however, that access would be an issue for some since some of the treatments that are not covered by insurance.
Policy changes and further research could help with better outcomes for men in chronic pain, Leonard said, and help clear away some of the roadblocks to access.
For example, the SUPPORT For Patients And Communities Act of 2018 required that the FDA issue guidelines on the development of nonaddictive pain medications, he noted. Therefore, this trends pharmaceutical developers towards drugs that are effective but safer to use long-term.
Another of several examples given was in regard to the HEAL Initiative involving the National Institutes of Health.
The NIH collects data from sources such as patients to better understand the biological underpinnings of pain. With such knowledge, a “signature” of pain will be created, to see who is more and less likely to develop pain from surgery or injury. Branching off from that data, better non-addictive pain care can then be developed specifically for the unique biology of those groups of individuals.
Access to current pain treatments must also be improved, Leonard confirmed, and the accessibility to future treatments should be equally unhindered.
The free webinar can be viewed on www.youtube.com under the MHNMedia account